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Psychological Problems in Children With Cancer in the Initial Period of Treatment

Gerali, Maria PhD; Servitzoglou, Marina MD, PhD; Paikopoulou, Dimitra PhD; Theodosopoulou, Helen PhD; Madianos, Michael MD, PhD; Vasilatou-Kosmidis, Helen MD, PhD

doi: 10.1097/NCC.0b013e3181fa5698

Background: The increasing survival rate of children with cancer because of more refined treatments makes necessary the investigation of psychological burden for the young patients.

Objective: The aim of the study was to evaluate the development of psychological problems in children with cancer during the initial 6-month period of intensive treatment.

Methods: This prospective, comparative study was conducted at one of the largest Greek pediatric oncology units in Athens. The sample comprised 132 children with cancer treated during a 30-month period and 100 children with no cancer as control group. Data were collected using the Rutter instruments for parents and teachers. For patients, it was completed by their parents at 1 (T1), 3 (T2), and 6 months (T3) from diagnosis and by teachers at T3. In the control group, the questionnaire was completed by teachers and parents once.

Results: The comparison of total Rutter scores for patients at T1, T2, and T3, according to parents' responses, showed statistically significant difference (P < .001). The difference in scores for patients (at T3) and control subjects was also significant according to both parents' (P < .00001) and teachers' (P < .001) responses. Children with leukemia had higher score reduction during treatment (P = .009) compared with the rest. Only age had a marginal impact on score of patients at T1 (R 2 = 0.04).

Conclusions: Based on parental reports, children treated for cancer develop psychological problems during the period of intensive treatment. The development and evolution of these problems depend on their age and type of cancer.

Implications for Practice: This information can be used for relevant interventions in specific groups.

Author Affiliations: Nursing Education Office (Dr Gerali) and Oncology Unit (Drs Servitzoglou and Vasilatou-Kosmidis), Children's Hospital "P. & A. Kyriakou"; and Faculty of Nursing, University of Athens (Drs Paikopoulou, Theodosopoulou, and Madianos), Athens, Greece.

Correspondence: Marina Servitzoglou, MD, PhD, Oncology Unit, Children's Hospital "P. & A. Kyriakou," Thivon and Levadias, 11527 Athens, Greece (

Accepted for publication August 29, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.